1083096861 NPI number — JOUBIN BAKHTAR D.C.

Table of content: JOUBIN BAKHTAR D.C. (NPI 1083096861)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1083096861 NPI number — JOUBIN BAKHTAR D.C.

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
BAKHTAR
Provider First Name:
JOUBIN
Provider Middle Name:
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
D.C.
Provider Gender Code:
M

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
Provider Other First Name:
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:

NPI Number Information

NPI Number:
1083096861
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
09/02/2016
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
1340 OLD CHAIN BRIDGE RD.
Provider Second Line Business Mailing Address:
SUITE 300A
Provider Business Mailing Address City Name:
MCLEAN
Provider Business Mailing Address State Name:
VA
Provider Business Mailing Address Postal Code:
22101-3955
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
703-662-0220
Provider Business Mailing Address Fax Number:
571-814-3268

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
1340 OLD CHAIN BRIDGE RD.
Provider Second Line Business Practice Location Address:
SUITE 300A
Provider Business Practice Location Address City Name:
MCLEAN
Provider Business Practice Location Address State Name:
VA
Provider Business Practice Location Address Postal Code:
22101-3955
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
703-662-0220
Provider Business Practice Location Address Fax Number:
571-814-3268
Provider Enumeration Date:
06/29/2015

Additional Information

Authorized Official

Authorized Official Last Name:
Authorized Official First Name:
Authorized Official Middle Name:
Authorized Official Title or Position:
Authorized Official Telephone Number:

Provider Taxonomy Codes

  • Taxonomy code: 111N00000X , with the licence number:  0104557202 , registered in the state of VA ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)

  • Identifier: 1083096861 . This is a "NPI" identifier , issued by the state of ( VA ) . This identifiers is of the category "OTHER".




Copyright © 2007-2025 www.npivalidator.com